The purpose of this trial is to establish if several interventions will help women in rural Tanzania access health care services during pregnancy and at the time of delivery. The interventions include education about the importance of attending antenatal care visits with nurses and facility deliveries, a voucher for transport to access the health facility at the time of delivery, and supplies to be used either at the health facility, or on route if the women does not make it to the health facility.
In order to reduce the number of women dying in childbirth and to improve women's health in pregnancy, this trial is designed to assess if several interventions combined can increase the number of women delivering in health care facilities. The design of the study is "Multiple Baseline Design". Community health workers are trained to collect baseline data on women using mobile phones in one rural district in Tanzania. The district has four distinct divisions. After 6 months of baseline data in the district, one division will experience the interventions. The interventions are education about the importance of attending antenatal care visits with nurses and facility deliveries, a voucher for transport to access the health facility at the time of delivery, and birthing supplies to be used either at the health facility, or on route if the women does not make it to the health facility. The intervention will be begun in each of the other divisions in 3 month intervals (i.e. the second division starts to experience the interventions 3 months after the first, the third, 3 months after the second and the fourth 3 months after the third). The trial will continue for a total of 27 months including the baseline period.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
17,000
The interventions are: 1. Village meetings by community health workers to educate women and their families about safe birthing. 2. Vouchers for free transport by motorcycle taxi drivers to access health facility at delivery.
Provision of birth kit with clean delivery supplies (soap, 2 pairs of gloves, 2 cord clamps, surgical blade, and 600 mcg misoprostol for the woman to take immediately after the delivery to prevent postpartum hemorrhage).
Shirati District Hospital Research Office
Shirati, Rorya District, Mara, Tanzania
Facility births
Number of women attending health facilities for delivery
Time frame: During baseline vs during intervention periods until end of study (2 years)
Antenatal Care visits
Number of times women attend health facility for antenatal visits
Time frame: During baseline vs during intervention until end of study (2 years)
Postpartum visits
Number of women attending health facility for postpartum visits
Time frame: During baseline vs during intervention until end of study (2 years)
Use of transport intervention
Number of women using the free transport intervention
Time frame: During Intervention until end of study (2 years)
Use of birth kit
Number of women using the birth kit
Time frame: During Intervention until end of study (2 years)
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